NSG223 VERIFIED EXAM 2
REVISION STUDYGUIDE
What is the most comfortable position for patient with
pulmonary edema?
dangling legs***
pulmonary edema
accumulation of fluid in the lungs, alveolar space, or both
symptoms of pulmonary edema
- dyspnea
- cough
- crackles
- blood-tinged sputum***
Diagnostics for pulmonary edema
- chest x-ray
- history and physical
- BNP
treatment for pulmonary edema
diuretics***
respiratory failure
- PaO2 <60 mmHg
- increase of PaCO2 > 50 mmHg
- pH < 7.35
acute respiratory failure
- sudden life-threatening deterioration of the gas exchange
function of the lung
- failure of the lungs to provide adequate oxygenation or
ventilation for the blood
,chronic respiratory failure
- deterioration in gas exchange function of the lungs that
has developed slowly over time
- due to COPD, neuromuscular disease
signs of respiratory failure
- dyspnea
- tachycardia
- elevated BP
- headache
- confusion
- cyanosis
management of respiratory failure
- oxygen
- elevate head of bed
- intubate (if needed)
acute respiratory distress syndrome (ARDS)
- sudden, progressive pulmonary edema
- lungs rapidly fill up with fluid
- does not respond to oxygen
signs of ARDS
- rapid onset of severe dyspnea
- hypoxemia (does not respond to oxygen)
- crackles
- tachycardia
- retractions
risk factors for ARDS
- history of lung injury
- history of infection (pneumonia 2 weeks ago)
- sepsis
- major surgery
- prolonged inhalation of smoke, corrosive substances
, treatment for ARDS
- intubation***
- PEEP*** (positive end expiratory pressure) setting -
prevents alveoli from collapsing
- vasopressors (increase BP)
- sedatives (lorazepam, versed, propofol)
- neuromuscular agents for paralysis
(pavulon, norcuron*** - relaxes jaw and vocal cords)
- frequent respiratory and cardiac assessments
- prone position
- train of 4 (electrical stimulation to check for sedation - no
twitches means 100% sedation)
goals for patient with ARDS
- PaO2 is >60 mmHg
- V/Q balance (amount of air reaching alveoli/amount of
blood reaching alveoli - ideal 4L/5L)
venous thrombus emboli (VTE)***
includes pulmonary embolism (PE) and deep vein
thrombosis (DVT)
pulmonary embolism
- obstruction of the pulmonary artery or one of its
branches, causing increased pressure
- similar to a heart attack but occurs in the lungs
- caused by blood clot, fat embolism, or air
- death can occur in 1 hour of symptom development
signs of PE
- dyspnea
- tachycardia
- bloody sputum
- cough
- chest pain
REVISION STUDYGUIDE
What is the most comfortable position for patient with
pulmonary edema?
dangling legs***
pulmonary edema
accumulation of fluid in the lungs, alveolar space, or both
symptoms of pulmonary edema
- dyspnea
- cough
- crackles
- blood-tinged sputum***
Diagnostics for pulmonary edema
- chest x-ray
- history and physical
- BNP
treatment for pulmonary edema
diuretics***
respiratory failure
- PaO2 <60 mmHg
- increase of PaCO2 > 50 mmHg
- pH < 7.35
acute respiratory failure
- sudden life-threatening deterioration of the gas exchange
function of the lung
- failure of the lungs to provide adequate oxygenation or
ventilation for the blood
,chronic respiratory failure
- deterioration in gas exchange function of the lungs that
has developed slowly over time
- due to COPD, neuromuscular disease
signs of respiratory failure
- dyspnea
- tachycardia
- elevated BP
- headache
- confusion
- cyanosis
management of respiratory failure
- oxygen
- elevate head of bed
- intubate (if needed)
acute respiratory distress syndrome (ARDS)
- sudden, progressive pulmonary edema
- lungs rapidly fill up with fluid
- does not respond to oxygen
signs of ARDS
- rapid onset of severe dyspnea
- hypoxemia (does not respond to oxygen)
- crackles
- tachycardia
- retractions
risk factors for ARDS
- history of lung injury
- history of infection (pneumonia 2 weeks ago)
- sepsis
- major surgery
- prolonged inhalation of smoke, corrosive substances
, treatment for ARDS
- intubation***
- PEEP*** (positive end expiratory pressure) setting -
prevents alveoli from collapsing
- vasopressors (increase BP)
- sedatives (lorazepam, versed, propofol)
- neuromuscular agents for paralysis
(pavulon, norcuron*** - relaxes jaw and vocal cords)
- frequent respiratory and cardiac assessments
- prone position
- train of 4 (electrical stimulation to check for sedation - no
twitches means 100% sedation)
goals for patient with ARDS
- PaO2 is >60 mmHg
- V/Q balance (amount of air reaching alveoli/amount of
blood reaching alveoli - ideal 4L/5L)
venous thrombus emboli (VTE)***
includes pulmonary embolism (PE) and deep vein
thrombosis (DVT)
pulmonary embolism
- obstruction of the pulmonary artery or one of its
branches, causing increased pressure
- similar to a heart attack but occurs in the lungs
- caused by blood clot, fat embolism, or air
- death can occur in 1 hour of symptom development
signs of PE
- dyspnea
- tachycardia
- bloody sputum
- cough
- chest pain
